HomeMy WebLinkAboutMechanical 00-0872 ClTY~F PRIOR LAKE
· INSPECTION NOTICE
ADDRESS
OWNER
PHONE NO.
[] FOOTING
[] FOUNDATION
[] FRAMING
[] INSULATION
~ FINAL
· [] SITE INSPECTION
COMMENTS:
[] WORK SATISFACTORY, PR(
[] CORRECT ACTION AND PR(
ii'CORRECT WORK, CALL FOI
Inspector: ~ ~
CALL 447-9850 FOR THE
CODE REQUIREMENTS A
DATE
CONTR.
PERMIT NO.
PLUMBING RI
MECH RI
WATER HOOKUP
SEWER HOOKUP
PLUMBING FINAL
MECH FINAL
TIME
/~', 3a
[] EX/GRAD/FILLING
[] COMPLAINT
[] FIREPLACE RI
[] FIREPLACE FINAL
[] GASLINE AIR TST
[]
rCEED
.CEED
: REINSPECTION BEFORE COVERING
Owner/Contr:
NEXT INSPECTION 24 HOURS IN ADVANCE.
FOR YOUR PERSONAL HEALTH & SAFETY!
CITY OF PRIOR LAKE
16200 Eagle Creek Av. S.E. Permit No. Prior Lake, MN 55372
HEATING APPLICATION / PERMIT
Date ~-~ -'~::~ %' ~
Lot Block ~ Addition
Owner's Name C'-.-~"X ~
He~ing ~ntra~or ~ ~
Telephone # ~'-'~ - Qb \'~
Furna~ Make & Model k-k~,~ ~
Conn. Load
Supply Openings
Return Openings
Input Output
Edr.
Cfm.
TYPE OF SYSTEM
Warm Air Plants
Gravity
Mechanical
Air Conditioning
Vent. System
HEATING OR POWER PLANT
Steam
Hot Water
9.~Radiation
~'~" Special Devices
Alterations
Repair
Est. Cost $ ~:~ ~.%~'~ ~'_~ ~ Building Permit #
HEATING PERMIT FEE $ ~ (~
STATE SURCHARGE $ .50
TOTAL PERMIT FEES ,~k,~...~ ~'~ Receipt#
TYPE OF WORK
Replacement ~ New Construction
Est. Comp. Date C~ - '~ <;~. ~ ~.~
TYPE OF STRUCTURE
1. Pink
2. Green
3. Yellow
File
City
- Contractor
Single Family
Commercial
Two-Family
Industrial
Multi-Family
Public Other
Fee Schedule
Industrial, Commemial & Multi-Family
Residential, Heating & AC
Residential, Heating Only
Residential, Gas Fireplace
Residential, Additions & Alterations
Residential, AC Only
1%ofjob co~ ($39.50 minimum)
$99.50
$64.50
$39.50
$39.50
$39.50
Remember to add the State Surcharge on the bottom of this application.
The price of your heating permit includes one rough-in and one final inspection.
Additional inspections will be billed at $35.00 each.
House Heating Test Record must be submitted with building _Dermit number before build-
ing certificate of occupancy will be issued.
HEAT (~A[.CULATIONS REQUIRED with number of supply and return openings listed per
room with CFM's per opening. New structures or additions send floor plan with supply
and return locations shown. HEAT LOSS CALCULATIONS, PAYMENT AND
APPLICATIONS MAY BE MAILED TO THE CITY OF PRIOR LAKE, 16200 EAGLE
CREEK AVE. S.E. PRIOR LAKE, MN 55372.
City Hall business hours are 8 a.m. - 4:30 p.m.
ALL WORK MUST BE INSPECTED (ROUGH-IN AND FINAL) - CALL CITY HALL
447-4230
I hereby apply for a mechanical systems permit and I acknowledge that the
information above is complete and accurate; that the work will be in conformance
with the ordinances and codes of the city and with the state building/mechanical
codes; that this form does not become a permit until signed by the BUILDING
OFFICIAL; that the work will be in accordance with the approved plan in the
case of all work which requires review and approval of plans.
Date
Date
~-8124~ Fax (612) 447-8128
~ -~ATING, coOLING & VENTILATION
16980 WELCOME AVE., S.E. · PRIOR LAKE, MN 55372
-'7,.~- oO
* Heafirtg Corlfl'lCtO~ METRO AIR
*Tester~/Signatur~~
Pressurized
Inspected
* Percent CO2
*Percent 02
Final Inspection
Pounds
Dat._..~e Time Pressure
PERFORMANCE TEST
<~r (~D *Percent CO ~
"'/ 0'~'0 *Stack Temp.._~.~'OF
Date